Caregivers’ Understanding of Ingredients in Drinks Served to Young Children: Opportunities for Nutrition Education and Improved Labeling

Abstract

Background Against expert recommendations, sugar-sweetened beverages, especially fruit drinks, are consumed by young children. Misperceptions about drink ingredients and healthfulness may contribute to caregivers’ provision. Objective Assess caregivers’ reasons for serving sweetened fruit-flavored drinks and unsweetened juices to their young children (1-5 y) and perceptions of product healthfulness and drink ingredients. Methods Cross-sectional online survey assessed participants’ (n = 1,614) perceptions of sweetened fruit-flavored drinks (fruit drinks and flavored water) and unsweetened juices (100% juice and water/juice blends) provided to their child in the past month, including product healthfulness, reasons for providing, and knowledge of product ingredients (added sugar, non-nutritive sweeteners (NNS), percent juice). One-way analysis of variance compared perceived healthfulness of drink categories and types of sugar and NNS and differences between participants who could versus could not accurately identify drink ingredients. Results Participants’ top reasons for providing sweetened drinks included child liking it, being inexpensive, child asking for it, and being a special treat. Participants perceived 100% juice as healthiest, followed by juice/water blends, flavored waters and lastly, fruit drinks (p<0.05). Many participants inaccurately believed the fruit drink or flavored water they served their child most often did not contain NNSs (59.0 and 64.9%) and/or added sugars (20.1 and 42.2%), when in fact they did, and 81.3-91.1% overestimated the percent juice in the drink. Perceived healthfulness of fruit drinks was associated with caregivers’ belief that the drink contained added sugar (p<0.05), but not with their belief that it contained NNS; increased accuracy was associated with decreased perceived healthfulness (p<0.05). Conclusions Inaccurate understanding of added sugar, NNS and percent juice in drinks served to young children was common and may contribute to sugary drink provision. Public health efforts should seek to improve labeling practices and revise nutrition education messages.

The nutritional profile of commercial complementary foods in Japan: comparison between low- and high-price products

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Caregivers’ provision of sweetened fruit-flavoured drinks to young children: importance of perceived product attributes and differences by socio-demographic and behavioural characteristics

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“…Unfortunately, there is scant evidence that warning labels and excise taxes help achieve health equity across vulnerable populations. The Center for Science in the Public Interest conjectures warning food labels should be accessible to those of varying nutrition and numeracy literacy and designed in a way that is easily understood across all racial/ethnic groups [79] , [80] , [81] .…”